Sunday, April 4, 2004

Insurance changed and bills soared



CHRONIC ILLNESS
Lisa James
Lisa James at her daughter, Nikkia's monthly six-hour sickle-cell anemia treatment to reduce iron in her blood.
(Meggan Booker photo)

LISA JAMES
39, Blue Ash

Type of insurance coverage: Employer-offered managed care plan

Health coverage premium: About $600 a month for family coverage

Family health bills: Thousands per year for care related to sickle cell anemia

Like one of every 500 African-Americans, Lisa James was born with sickle cell anemia. So were two of her five siblings. So was her 19-year-old daughter, Nikkia.

Even though her condition is in generally good control, Lisa still requires regular monitoring, occasional blood transfusions and hospital care during painful "flare-ups" of the blood disorder.

For many years, nearly all her bills were covered by health plans provided by her husband's employers, General Electric and Belcan Corp. But when he took a new job in Michigan, it turned into a coverage nightmare so serious he moved back to Cincinnati.

"We started getting a whole bunch of bills. Thousands of dollars. We paid for some of them with our income tax returns. We're still paying for some of them," Lisa James says.

The couple has since divorced, but she remains covered through his employer.

Paying the high costs of chronic illness is one of the toughest problems in health benefits today.

More than 36 percent of large employers are considering disease management programs to pay for preventive care before complications lead to expensive hospital stays.

But most people work in jobs where the health plan doesn't pay for preventive care or limits coverage of maintenance supplies.

James says she now appreciates her coverage. "It didn't dawn on me how much we were blessed with good benefits," she says.

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Though happy with his coverage, Rich Hancock worries as his parents spend more for health care.
Lisa James CHRONIC ILLNESS
Insurance changed and bills soared
When Lisa James' husband took a new job, it turned into a coverage nightmare.
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Keith Glassmeyer says health-care benefits are the biggest concern among fellow workers.
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Betty Stevens joined an HMO in the '90s, and saved money at first. She's now less satisfied.
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